Medical Center Archives - Woods Services

Woods System of Care’s Three Outpatient Healthcare Centers in Langhorne, Pa. Welcome Patients for Primary, Dental, and Behavioral Healthcare

May 18, 2023

Woods Healthcare Opens to the Community, Providing Exceptional Outpatient Health and Behavioral Care for Individuals with Intellectual and Developmental Disabilities, Autism, and Emotional and Behavioral Challenges

Woods System of Care, a network of healthcare organizations located in Pennsylvania and New Jersey that ensures lifelong support to individuals with disabilities, has launched Woods Healthcare to offer world-class outpatient health and behavioral care for children, adolescents, and adults in the community with intellectual and developmental disabilities, autism, and emotional and behavioral challenges. Woods Healthcare includes three outpatient healthcare centers – The Center for Behavioral Health at Woods, The Medical Center at Woods, and Penn Dental Medicine at Woods Mikey Faulkner Dental Care Center – which are now open to the community. The three centers are located on the Bucks County site of Woods Services at 10 Meadowood Drive in Langhorne, Pa. Community members can now make appointments by calling 215-750-4004 and learn more at www.woodshealthcare.org.

“With the launch of Woods Healthcare, we are building on a long tradition of experience and service to our community,” said Tine Hansen-Turton, president and CEO of Woods System of Care and Woods Services. “For more than a century, Woods has been a leader in providing comprehensive lifelong care to support people with intellectual and developmental disabilities, autism, and emotional and behavioral challenges at Woods. Our industry-leading specialists know how to break down the barriers that stand in the way of quality care for people with disabilities,” she said. “Now, with Woods Healthcare, we are expanding our services to support the community by providing individuals with disabilities access to world-class comprehensive primary care, dental care, and behavioral healthcare throughout their lifetime.”

The Center for Behavioral Health at Woods specializes in helping people with intellectual and developmental disabilities, autism, and emotional and behavioral challenges achieve their highest potential and independence. With a wellness team that includes psychiatrists, psychiatric nurse practitioners, psychologists, nurse navigators, counselors, and family therapists, The Center for Behavioral Health at Woods provides outpatient services for individuals ages six years through adults and seniors, including: intake, psychiatric, and diagnostics assessments; medication review and coordination; complex condition nurse navigation; and extended therapy. The Center for Behavioral Health at Woods also evaluates children ages 12 months through adolescents aged 18 years for autism spectrum disorder, making diagnoses and treatment recommendations. Sailaja Musunuri, MD, executive vice president of Integrative Medicine and Chief of Psychiatry, oversees integrated healthcare at Woods and across the Woods System of Care, including the new Center for Behavioral Health at Woods.

The Medical Center at Woods, which is led by Dr. Stephen J. Kolesk, chief medical officer/vice president for Medical Affairs and Managed Care at Woods, provides primary care for people with intellectual and developmental disabilities, autism, and emotional and behavioral challenges. The Medical Center offers outpatient services for individuals ages six through adults and seniors. The Medical Center at Woods serves as a national model for providing comprehensive, coordinated personalized care for people with complex diagnoses and medical conditions. In April 2023, the Medical Center at Woods was awarded Recognition by the National Committee for Quality Assurance Patient-Centered Medical Home Program (www.ncqa.org).

Penn Dental Medicine at Woods, Mikey Faulkner Dental Care Center is a state-of-the-art dental care center providing enhanced and leading-edge dental treatment for individuals of all ages. Woods partnered with the University of Pennsylvania School of Dental Medicine, one of the leading dental schools in the United States, to develop the dental program, and Dr. Marc Henschel, director of Penn Dental Medicine’s Advanced Education in General Dentistry program, oversees the new center. The Woods facility includes five treatment rooms with advanced equipment, quiet space for those needing a lower-stimulation environment, a waiting area and reception check-in, and conference room. In addition to meeting the dental care needs of individuals with disabilities, Penn Dental Medicine at Woods, Mikey Faulkner Dental Care Center is helping prepare the next generation of dentists to care for patients with disabilities.

“We launched the Medical Center at Woods in June 2018, to provide a patient-centered medical home for the clients we serve and our Woods employees,” Hansen-Turton said. “We added Penn Dental Medicine at Woods in February 2023, followed by The Center for Behavioral Health in March. Now, we are opening these centers to the community, providing people with intellectual and developmental disabilities, autism, and emotional and behavioral challenges with needed services in close proximity to their homes,” she said.

Start-up funding of $500,000 for The Center for Behavioral Health was awarded to Woods by Congressman Brian Fitzpatrick through a Community Project Funding grant. The project was supported by SAMHSA (Substance Abuse and Mental Health Services Administration) and selected because it will bridge the gap in mental health services in Bucks County. Penn Dental Medicine at Woods Mikey Faulkner Dental Care Center renovations and operational expenses were made possible through generous donations from foundations and individuals. Woods Services is grateful to the Donald B. and Dorothy L. Stabler Foundation for supporting start-up operational expenses and to the Joseph and Mary Faulkner Family Foundation, Eamon Foundation, The McLean Contributionship, TD Charitable Foundation, and Simon and Lisa Kimmelman for supporting the renovations, and Penn Community Foundation for funding operations. The waiting room renovation was made possible by the Joseph and Mary Faulkner Family Foundation.

In early 2024, the three new Woods Healthcare centers will be joined by a primary care center to serve individuals in N.J. In April 2023, RWJBarnabas Health, Rutgers University Behavioral Health Care, and Woods Services announced they joined forces to establish the very first integrated primary and behavioral health care center for individuals with intellectual and developmental disabilities and autism in New Jersey. The Governor and the New Jersey Legislature recognized the critical need for I/DD services by supporting a grant of $800,000 toward the start-up costs for the initiative. The world-class center is expected to open to families and individuals in early 2024 at Robert Wood Johnson University Hospital Hamilton in Hamilton, Mercer County, New Jersey. The Center will serve individuals who live in the central New Jersey region, with future plans to expand services to other areas of the state.

Woods is organized around the principles of population health management and addresses the social determinants of health through a comprehensive continuum and system of care that connects prevention, wellness, education, behavioral health, and social services with coordinated and integrated healthcare delivery.

For more information about Woods Healthcare or to schedule an appointment at one of its three outpatient centers, call 215-750-4004.

About Woods Services

Woods Services is a nonprofit organization that supports children, adolescents, and adults with complex medical and behavioral health care needs, including intellectual and developmental disabilities, achieve their highest potential and independence through innovative and individualized approaches that promote learning and personal fulfillment. Woods’ vision is a world where individuals have opportunities and supports that promote self-determination, dignity, respect, the joy of achievement, and a fulfilling life. Woods achieves this vision by providing comprehensive and integrated health, education, housing, workforce development, behavioral health, and case management services, along with a population health management strategy that includes the integration of primary and specialty medical care with behavioral health. More than 600 individuals from 23 states and 175 school districts are supported by Woods and its 1,400 staff at its Langhorne, Pennsylvania headquarters.

To ensure lifelong care and supports for the individuals its serves, Woods created the Woods System of Care – a $400 million organization with 10 affiliates and joint ventures that provide a full range of lifetime integrated services that include mental and physical healthcare, education, housing and residential treatment and workforce development for an estimated 22,000 children and adults with intellectual disabilities, autism, and /or mental health challenges who may also have complex medical and genetic conditions.

Founded in 1913 by Philadelphia schoolteacher Mollie Woods to advance the quality of life and standard of care for individuals with disabilities, Woods continues this mission today. For more information, visit woods.org.

About University of Pennsylvania School of Dental Medicine

Founded in 1878, the University of Pennsylvania School of Dental Medicine (Penn Dental Medicine) ranks among the nation’s leaders in oral health education, research, and patient care. The School’s educational programs include: a four-year DMD program; postgraduate study in all the major clinical specialties as well as general dentistry; advanced graduate degree programs, including Doctor of Science in Dentistry, Master of Science in Oral Biology, Master of Advanced Dental Studies, and Master of Oral Health Science; and the Program for Advanced Standing Students in which foreign-trained dentists earn a DMD. As one of 12 schools within the larger urban campus of the University of Pennsylvania, Penn Dental Medicine is uniquely positioned to provide a depth of opportunities for interdisciplinary study and research across other professional disciplines. The School is a major provider of oral health care for the Philadelphia community, serving approximately 31,000 patients each year in its care centers and Penn Dental Family Practice, while students also provide nearly 65,300 hours of clinical care in the community each year.

Woods Services, RWJBarnabas Health and Rutgers University Behavioral Health Care Partner to Open the First New Jersey–based Integrated Primary Care and Behavioral Health Care Center for Individuals with Intellectual and Developmental Disabilities and Autism

April 18, 2023

New Jersey’s largest provider of I/DD services joins the state’s largest hospital system to dramatically improve access to care for an underserved population

RWJBarnabas Health, Rutgers University Behavioral Health Care, and Woods Services, are joining forces to establish the very first integrated primary and behavioral health care center for individuals with intellectual and developmental disabilities (I/DD) and autism in New Jersey.

The Governor and the New Jersey Legislature recognized the critical need for I/DD services by supporting a grant of $800,000 toward the startup costs for the initiative. The world-class center is expected to open to families and individuals in early 2024 at Robert Wood Johnson University Hospital Hamilton in Hamilton, Mercer County, New Jersey. The Center will serve individuals who live in the central New Jersey region, with future plans to expand services to other areas of the state.

By providing equitable access to primary, specialty, and behavioral health services, this Center will improve health outcomes and reduce the overall costs of care for children and adults with I/DD and autism, and related behavioral and medical conditions, many of whom currently face a severe lack of services.

Individuals with intellectual disabilities traditionally have poor health outcomes and a life expectancy that is nearly 20 years below that of the general population. Many have multiple severe conditions that require highly specialized services and careful care coordination across medical, social, and community services. Communication barriers, mobility issues, and severe mental or behavior concerns make care needs complex and difficult to access, creating significant health inequities. Furthermore, there is an extreme shortage of providers who can or will work with this complex population of largely Medicaid recipients, in part because of the need for longer office visits and specialized skills, lack of accessible medical offices, and low reimbursement rates. As a result, gaps in care are common and people in this population experience significant disparities in access to care and health outcomes.

This Center will address and overcome these barriers by providing innovative, comprehensive, and coordinated care across primary, specialty, and behavioral health settings. Patients of the center may receive comprehensive medical and behavioral services onsite or through outpatient telehealth and in-home visits. The addition of telehealth will extend the program’s reach and remove barriers to care that are unique to the I/DD and autistic populations.

“We are excited to partner with RWJBarnabas Health and Rutgers University Behavioral Health Care to bring Woods’ highly successful and leading edge Patient-Centered Primary Care Model to New Jersey,” said Tine Hansen-Turton, Woods President and CEO. “Through the Medical Center at Woods, our model has shown that providing integrated primary care and behavioral healthcare can increase both access to and quality of care and, at the same time, lower overall Medicaid and Medicare cost of care by at least 20% by decreasing emergency room visits and inpatient hospitalization.”

“This new partnership highlights our shared commitment to increasing the capacity of existing primary care and behavioral health providers serving individuals with I/DD, ensuring that these patients receive the attention and specialized care they deserve,” said Frank A. Ghinassi, PhD, ABPP, Senior Vice President of Behavioral Health and Addictions services at RWJBarnabas Health and President and CEO of Rutgers University Behavioral Health. “Building a robust program of experts and a network of providers dedicated to caring for the I/DD population is a major step forward in addressing the gaps in care that these patients face all too often.”

About Woods Services and System of Care

Woods Services is a nonprofit, life cycle care management and advocacy organization that, along with six affiliate organizations located in Pennsylvania and New has formed a System of Care which provides innovative, comprehensive, and integrated health, education, housing, workforce, behavioral health, and case management services to more than 22,000 children and adults in the intellectual and developmental disability, mental health public health sectors who have complex and intensive medical and behavioral healthcare needs. For more information, visit woods.org.

About RWJBarnabas Health

RWJBarnabas Health is the largest, most comprehensive academic health care system in New Jersey, with a service area covering eight counties with five million people. The system includes twelve acute care hospitals – Clara Maass Medical Center in Belleville, Community Medical Center in Toms River, Cooperman Barnabas Medical Center in Livingston, Jersey City Medical Center in Jersey City, Monmouth Medical Center in Long Branch, Monmouth Medical Center Southern Campus in Lakewood, Newark Beth Israel Medical Center in Newark, Robert Wood Johnson University Hospital in New Brunswick, Robert Wood Johnson University Hospital Somerset in Somerville, Robert Wood Johnson University Hospital Hamilton in Hamilton, Robert Wood Johnson University Hospital Rahway in Rahway and Trinitas Regional Medical Center in Elizabeth, three acute care children’s hospitals, Children’s Specialized Hospital with a network of outpatient pediatric rehabilitation centers, a freestanding 100-bed behavioral health center, two trauma centers, a satellite emergency department, ambulatory care centers, geriatric centers, the state’s largest behavioral health network, comprehensive home care and hospice programs, fitness and wellness centers, retail pharmacy services, affiliated medical groups, multi-site imaging centers and two accountable care organizations.

RWJBarnabas Health is among New Jersey’s largest private employers – with more than 38,000 employees and 9,000 physicians– and routinely captures national awards for outstanding quality and safety. RWJBarnabas Health launched an affiliation with Rutgers University to create New Jersey’s largest academic health care system. The collaboration aligns RWJBarnabas Health with Rutgers’ education, research and clinical activities, including those at the Rutgers Cancer Institute of New Jersey – the state’s only NCI-designated Comprehensive Cancer Center – and Rutgers University Behavioral Health Care.

About Rutgers University Behavioral Care

Rutgers University Behavioral Health Care (RUBHC) provides a myriad of programs to address behavioral and physical health with individuals, families and communities throughout their lifespan. Services include all levels of care, such as inpatient, outpatient, community-based programs, integrated physical and behavioral health and 24-hour national peer help lines. RUBHC is dedicated to advancing science through programmatic research and educating the current and next generation of health care professionals.

Woods Services Awarded $100,000 Grant to Expand Access to Primary Care for People with Intellectual Disabilities

April 8, 2021

Woods, a New Jersey- and Pennsylvania-based life cycle care management organization, received one of the first Inclusive Health Communities Grants from the N.J. Department of Human Services’ Division of Disability Services

LANGHORNE, P.A. (April 5, 2021) –Woods Services, a Pennsylvania and New Jersey-based nonprofit organization, was recently awarded a $100,000 capacity building grant to increase access to primary care for people with intellectual and developmental disabilities (IDD) and mental health challenges who experience significant disparities in access to care and health outcomes. With the funding, Woods will establish an integrated and inclusive primary care practice within or adjacent to Salem Medical Center, a hospital destination of choice for those living in or around Salem County, N.J. The initiative is funded by an Inclusive Healthy Communities Grant from the Division of Disability Services, New Jersey Department of Human Services, and administered by Rutgers University Bloustein School of Public Policy and Planning. Woods is one of the first recipients of an Inclusive Health Communities Grant, a program that launched in January. This national initiative of the Centers for Disease Control and Prevention focuses on policy, systems and environmental change to create inclusive healthy communities.

Woods’ project, titled “Expanding Access to Primary Care for People with Intellectual Disabilities,” will be implemented over the next nearly 18 months. Other program partners include Woods’ affiliates Allies, Inc., located in Hamilton Township, N.J., and Legacy Treatment Services in Mount Holly, N.J., that along with three other human services nonprofits, comprise Woods’ life-cycle management and advocacy organization serving 22,000 people with disabilities in Pennsylvania and New Jersey.

Woods will conduct a needs assessment of health care access and experience among people with disabilities, their families and provider organizations to further inform project planning. In addition, an inclusive primary care practice will be established over the 18-month timeline, serving community members with and without disabilities in Salem County and surrounding areas. Outcomes will be documented and shared. The health care model proposed will be replicable throughout New Jersey where there are documented shortages of primary care providers and gaps in services.

The grant builds on the successful patient-centered medical home model employed by the Medical Center at Woods located at the Langhorne campus. Woods utilizes quality care coordination as well as the deployment of nurse practitioners as primary care providers. Woods’ model places an emphasis on prevention and management of chronic conditions thereby reducing unnecessary and costly emergency room (ER) visits and hospitalizations.

Children and adults with IDD and mental health challenges experience multiple barriers to healthcare access, including finding providers who are willing to take the time often needed for longer patient visits and are trained to overcome communication, behavioral or other challenges. Additionally, children and adults with IDD and behavioral challenges tend to have more complex medical issues than those without. When their intellectual disability is linked to a variety of genetic disorders, the medical challenges may significantly exceed those of persons without such genetic conditions.

The proposed primary care settings are adapted to mobility, communication and sensory needs, delivered by providers who are well-versed in the care of people with disabilities and complex needs, and who are able to accommodate and overcome barriers to care resulting from those complex challenges. The project will focus primarily on Salem County and adjacent counties which have gaps in access to care, and where project partners have a strong presence serving individuals with IDD and mental health challenges and their families.

“As a life-cycle care management organization, we are grateful for this grant that will enable people with intellectual and developmental disabilities and challenges to receive first-rate healthcare in a setting that meets their needs, provided by people with expertise in treating their complex conditions,” said Tine Hansen-Turton, president and CEO, Woods Services. “For many people with IDD and mental health challenges, who often have complicated medical needs, the ability to reduce environmental disruptions while providing them with exceptional healthcare is truly a game changer.”

“We were truly excited to support Woods in their grant-seeking efforts to bring integrated and primary care services for people with intellectual disabilities,” said Dr. Tammy Torres, CEO, Salem Medical Center. “Bringing these behavioral health services to our community is part of our strategic vision building on the opening of our adult Psychiatric Unit by bringing in complementary and integrated mental health programming.”

This initiative was funded (or funded in part) by an Inclusive Healthy Communities Grant from the Division of Disability Services, New Jersey Department of Human Services.

About Woods Services

Woods Services is a nonprofit, life cycle care management and advocacy organization that, along with five affiliate organizations located in Pennsylvania and New Jersey – Allies, Inc., Archway Programs, Legacy Treatment Services, Tabor Services, and Woods Community at Brian’s House – provides innovative, comprehensive, and integrated health, education, housing, workforce, behavioral health, and case management services to more than 20,000 children and adults in the intellectual and developmental disability, behavioral, child welfare, and brain trauma public health sectors who have complex and intensive medical and behavioral healthcare needs. Founded in 1913 by Philadelphia schoolteacher Mollie Woods with two simple goals – to advance quality of life and standard of care for individuals with disabilities – Woods Services continues its mission today by helping children and adults with disabilities or challenges to achieve their highest potential. Among the ways Woods does this is through its population health management strategy, which includes the integration of primary and specialty medical care with behavioral health in Pennsylvania and New Jersey. For more information, visit woods.org.

About Salem Medical Center

With a mission of delivering high quality, compassionate healthcare to Greater Salem County, SMC returned to not-for-profit status in 2019. Salem Medical Center is licensed for 126 beds, inclusive of medical-surgical, intensive care and behavioral health. SMC provides critical access to the community through its Emergency Department (nearly 20,000 patients annually), Surgery (outpatient/inpatient, about 2,500 cases annually) and Inpatient Acute Care (about 2,500 admissions annually). SMC has more than 200 physicians on staff. Salem Medical Center is dedicated to growing new services and recruiting physicians relevant to our community—making SMC a destination of choice for Salem County and surrounding areas.

The Philadelphia Inquirer | Opinion | How can employers improve healthcare access for workers? Consider worksite clinics

February 10, 2020

Tine Hansen-Turton and Neil Goldfarb, For the Inquirer

Healthcare costs continue to rise and the lack of coordinated primary care access is still a challenge, which means millions of employees use the emergency room for basic healthcare. To combat this, self-insured companies are beginning to create their own solutions by partnering or establishing their own health clinics at work locations or near their work locations.

Primary care is essential to prevention and early identification of disease, and has been shown to improve health and lower costs of care, especially by avoiding unnecessary visits to urgent care centers and emergency departments. Improving access through worksite and near-site clinics helps employers demonstrate their commitment to maintaining a healthy workforce, save money for the employers, and support employee goodwill and retention.

At a recent national forum sponsored by the Greater Philadelphia Business Coalition on Health, which brings together 51 employers in Southeastern Pennsylvania, companies of varying sizes from across the country, including Cerner, Comcast/NBC/Universal, and Clemens Food Group, discussed how they are grappling with healthcare access challenges for their employees. They agreed that they must innovate, and one of these innovations is to bring healthcare to their employees. For example, to address primary care access for its 24/7 workforce in Langhorne, Pa., Woods Services, a population health management provider in the intellectual developmental disability sector, established an onsite medical center, which offers free primary healthcare to all its employees.

The healthcare sector, either on its own or by advocating for policy changes, must address access to healthcare for all. In the meantime, employers must come up with resourceful solutions to support their employees by bringing them healthcare access. Where a worksite clinic is not feasible (i.e. workforce not concentrated in one geographic location), employers can explore options such as retail clinics, near-site clinics, mobile units that periodically visit the workplace, and telemedicine solutions. The important point is that employers should do something to expand access to high-quality primary care.

New Industry Leading Medical Center Opens at Woods Services

June 27, 2018

Today leadership from Keystone First and Woods Services officially marked the opening of the newly expanded Medical Center at Woods and the launch of a Patient Centered Medical Home (PCMH) program. This innovative PCMH serving individuals with significant intellectual and developmental disabilities (I/DD) and complex medical challenges, is a national model for providing more comprehensive, coordinated care for these vulnerable populations.

“Through this collaboration with Keystone First, the new Patient Centered Medical Home program and expanded Medical Center at Woods will allow us to improve care coordination, provide extended service hours to reduce disruptive ER visits, and increase access to more advanced medical services right here on our campus,” said Tine Hansen-Turton, President and CEO of Woods Services. “For many of our residents with complex medical needs, the ability to reduce environmental disruptions while providing them with first-rate medical care is truly a gamechanger.”

The new Medical Center and PCMH program will empower Woods to provide the Keystone First members in its care, as well as 500 other individuals Woods serves, with superior continuity of care to improve health outcomes. The launch is part of an overall population health management approach at Woods Services that is reliant on industry best practices, moving the industry forward with new solutions, and providing the Woods community with superior care and support.

In addition to those served by Woods, the Medical Center will also offer free, on-site primary medical care as a benefit to all 2,000 Woods employees and will serve as a community medical hub for qualifying neighbors with intellectual and developmental disabilities.

“We are proud to work with providers like Woods Services which share our commitment to making high quality, coordinated care accessible to those most in need,” said Keystone First Market President Joanne McFall. “The PCMH program will provide our members served by Woods with a medical home that will help them manage their health. We look forward to joinin

g Woods in this expansion of our respective missions.”

Providing medical care for the Woods community on its Bucks County campus is not new. However, in the past, Woods has relied on external resources such as the emergency room for service during evening and weekend hours, as well as for specialized services such as radiology. For people with developmental and intellectual disabilities, these abrupt environmental changes and exposure to medical professionals not familiar with their cases can be disruptive. In addition, regular reliance on emergency services for ongoing medical issues generates significant costs to the system. This new Woods PCMH program creates a team-based health care delivery model. It provides comprehensive and continuous medical care with extended hours and increased access to more specialized medical services for patients with complex health needs, with a goal of achieving maximal health outcomes and reducing unnecessary costs to the healthcare system.

Children and adults with I/DD experience multiple barriers to healthcare access that include finding providers who accept Medicaid and Medicare, are willing to take the time often needed for longer patient visits, and are trained to overcome communication, behavioral or other challenges. Additionally, children and adults with I/DD and behavioral challenges tend to have more complex medical issues than those without. When their intellectual disability is linked to a variety of genetic disorders, the medical challenges may significantly exceed those of persons without such genetic conditions. Because of these complexities, people with I/DD account for a significant portion of the Medicaid and Medicare spending.

As a first-of-its-kind program, this PCMH at Woods serves as a national model and is expected to be replicated by Woods in other similar communities across the country in coming years.

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About Woods Services

Woods Services is a nonprofit, multi-service population health management and advocacy organization that along with four affiliate organizations provides innovative, comprehensive and integrated health, education, housing, workforce, behavioral health and case management services to more than 4,000 children and adults in the intellectual and developmental disability, child welfare, behavioral and brain trauma public health sectors who have complex and intensive medical and behavioral healthcare needs. Founded in 1913 by Philadelphia schoolteacher Mollie Woods with two simple goals – to advance quality of life and standard of care for individuals with disabilities – Woods Services continues its mission today by helping children and adults with disabilities or challenges to achieve their highest potential. For more information, visit woods.org.

About Keystone First

Keystone First is a Medical Assistance (Medicaid) managed care health product offered by Vista Health Plan, Inc., an affiliate of Independence Blue Cross, in five southeastern Pennsylvania counties. Here at Keystone First, we are mission-driven and dedicated to helping members get care, stay well and build healthy communities. For more information, visit www.keystonefirstpa.com.

Independence Blue Cross and Vista Health Plan, Inc. are independent licensees of the Blue Cross and Blue Shield Association.